BackgroundGum chewing has been reported to enhance the intestinal function recovery after caesarean section, current perspectives and practice guidelines vary widely on the use of gum chewing, more studies on the role of gum chewing after caesarean section are needed.MethodsWe performed a comprehensive, systematic meta-analysis of randomized controlled trials (RCTs) on the efficacy of gum chewing after caesarean section. Studies were identified by searching EMBASE et al database (until June 30, 2016). Summary odd ratios or weighted mean differences with 95% confidence intervals were calculated for each outcome with fixed- or random-effects model.ResultsTen RCTs with a total of 1659 women were included in our meta-analysis. Gum chewing provided significant benefits in reducing the time to first passage of flatus, first defecation, first bowel sound, first bowel movement and the length of hospital stay, but not in the time to first feeling of hunger.ConclusionsGun chewing hastens the intestinal function recovery after caesarean section and offers a safe and inexpensive option. High-quality and larger-scale RCTs are still warranted to clarify the role of gum chewing in intestinal function recovery after caesarean section.

This study aimed to study the role of P2X7 in intracerebral hemorrhage (ICH)-induced secondary brain injury (SBI) and the underlying mechanisms. An autologous blood injection was used to induce ICH model in Sprague-Dawley rats, and cultured primary rat cortical neurons were exposed to oxyhemoglobin to mimic ICH in vitro. siRNA interference and over-expression of P2X7, agonists and antagonists of P2X7, p38 MAPK and ERK were exploited. The protein levels were assessed using Western blotting and immunofluorescence staining. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining and Fluoro-Jade B were conducted to detect apoptotic and degenerating neurons. The protein levels of P2X7, phosphorylated p38, ERK, active caspase-3 and NF-κB were significantly increased by ICH, which could be further increased by BzATP (P2X7 agonist) and reduced by BBG (P2X7 antagonist). And BzATP demonstrated a significant increase in cell death ratio and brain water content, while BBG led to a reverse results. In addition, Over- P2X7 increased the levels of P2X7, phosphorylated p38, ERK, active caspase-3 and NF-κB, and aggravated cell apoptosis, while si P2X7 resulted in opposite effects. Finally, the protein levels of phosphorylated P38 and active caspase 3 were decreased by BzATP plus Hydrochloride (p38 MAPK antagonist) and increased vy BBG plus Asiatic acid (p38 MAPK agonist), while the protein levels of phosphorylated ERK and NF-κB were decreased with BzATP plus Nimbolide (ERK antagonist) and increased with BBG plus Saikosaponin C (ERK agonist). This study demonstrates that inhibition of P2X7 could prevent ICH-induced SBI via MAPKs signaling pathway.

Background This meta-analysis was performed to assess the efficacy and safety of chewing gum in intestinal function recovery after colorectal cancer surgery. Methods A systematic search was conducted in PubMed, Embase, Science Direct, and Cochrane library for relevant randomized controlled trials (RCTs) published until April 2017. Summary risk ratios or weighted mean differences with 95% confidence intervals were used for continuous and dichotomous outcomes, respectively. Results 17 RCTs with a total number of 1845 patients were included. Gum chewing following colorectal cancer surgery significantly reduced the time to first passage of flatus (WMD −0.55; 95% CI −0.94 to −0.16; P = 0.006), first bowel movement (WMD −0.60; 95% CI −0.87 to −0.33; P < 0.0001), start feeding (WMD −1.32; 95% CI −2.18 to −0.46; P = 0.003), and the length of postoperative hospital stay (WMD −0.88; 95% CI −1.59 to −0.17; P = 0.01), but no obvious differences were found in postoperative nausea, vomiting, abdominal distention, pneumonia, and mortality, which were consistent with the findings of intention to treat analysis. Conclusions Chewing gum could accelerate the recovery of intestinal function after colorectal cancer surgery. However, it confers no advantage in postoperative clinical complications. Further large-scale and high-quality RCTs should be conducted to confirm these results.

BackgroundSaline fluid nebulization is highly recommend to combat the complications following tracheostomy, yet the understandings on the role of osmolality in saline solution for nebulization remain unclear.ObjectivesTo investigate the biological changes in the early stage after tracheostomy, to verify the efficacy of saline fluid nebulization and explore the potential role of osmolality of saline nebulization after tracheostomy.MethodsSprague-Dawley rats undergone tracheostomy were taken for study model, the sputum viscosity was detected by rotational viscometer, the expressions of TNF-α, AQP4 in bronchoalveolar lavage fluid were assessed by western blot analysis, and the histological changes in endothelium were evaluated by HE staining and scanning electron microscopy (SEM).ResultsStudy results revealed that tracheostomy gave rise to the increase of sputum viscosity, TNF-α and AQP4 expression, mucosa and cilia damage, yet the saline fluid nebulization could significantly decrease the changes of those indicators, besides, the hypertonic, isotonic and hypertonic saline nebulization produced different efficacy.ConclusionsOsmolality plays an important role in the saline fluid nebulization after tracheostomy, and 3% saline fluid nebulization seems to be more beneficial, further studies on the role of osmolality in saline fluid nebulization are warranted.

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